When someone experiences pains in their heel, you’re most likely to hear some people say you probably have a spur or Plantar Fasciitis. You ‘probably’ have Posterior Tibial Tendonitis is rarely something you’ll ever hear; however, it can be your reality.
Post-Tib Tendonitis as it is also called, is a strain placed on the posterior tibial tendon. This tendon runs along the inside of the ankle and the foot. When there is post-tibial tendon dysfunction (PTTD), the tendon does not function to hold up the arch, resulting in flat feet. This can lead to heel pain, arch pain, plantar fasciitis and/or heel spurs. With post-tib tendonitis, pain will be more severe upon weight bearing, especially while walking or running.
Plantar Fasciitis on the other hand is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, plantar fasciitis can be the outcome, which can also lead to heel pain, arch pain, and heel spurs.
See the similarity in terms of the regions experiencing pain?
Post-Tib Tendonitis occurs when the muscle is overused and the tendon (soft tissue) that connects the muscle to your bone is strained. Years of over-pronation (flattening of the feet) can also lead to PTTD. If you keep overusing the muscle, damage to the tendon builds up and tendonitis develops. At first the pain or swelling may come and go quickly, but eventually the problem may become more permanent.
Whereas Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following:
- – Over-pronation (flattening of feet) which results in the arch collapsing upon weight bearing.
- – A foot with an unusually high arch.
- – A sudden increase in physical activity.
- – Excessive weight on the foot, usually attributed to obesity or pregnancy.
- – Improperly fitting footwear.
Over-pronation (flattening of the feet) is the leading cause of plantar fasciitis. Over-pronation occurs during the gait (walking) process, when a person’s arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone. With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot, where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, since while resting, the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides.
Treatment and Prevention
You can reduce your symptoms by limiting activity to control the pain and swelling. Stay off your feet a few days, then slowly increase your activity. Rest allows the tissues in your foot to heal. Conservative (non-surgical) treatments, include wearing a foot arch support to reduce strain on the post tibial tendon, and prevent excessive stretching of the plantar fascia. The orthotic should also be designed with materials to comfort the foot and absorb shock.
Listed below are tips to prevent Post-Tib Tendonitis from recurring:
- – Wear shoes that provide cushioning, support and shock absorption.
- – Use orthotics with sufficient arch support that are constructed from shock absorbing, cushioning materials.
- – Vary exercise routines. The variety will keep one set of muscles from being under continuous stress.
The key for proper treatment is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an arch support is an effective device to reduce the over-pronation and allow the condition to heal. If you have unusually high arches, which can also lead to plantar fasciitis, cushion the heel, absorb shock, and wear proper footwear that will accommodate and comfort the foot.
- – Stretching exercises
- – Plantar fasciitis night splints
- – Steroid injections
- – Ultrasound therapy
- – Wearing shoes that have a cushioned heel to absorb shock, and elevating the heel with the use of a heel raise or heel cup. – These provide extra comfort, cushion the heel, and reduce the amount of shock and forces placed on the feet during everyday activities. Every time your foot strikes the ground, the plantar fascia is stretched.
You can reduce the strain and stress on the plantar fascia by following these simple instructions:
- – Avoid running on hard or uneven ground
- – Lose any excess weight
- – Wear shoes and orthotics that support your arch to prevent over-stretching of the plantar fascia.
While similar in some sensations and treatments, as can be seen above, the two conditions are not the same.
Your feet mirror your general health . . . cherish them!